Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Not Applicable

Completed

• Conditions: Behavior, Health
• Interventions: Behavioral: Contact information; Behavioral: Urgent care map; Behavioral: Self-triage chart

• Registration Number: NCT05787548
• Lead Sponsor: Geisinger Clinic

Brief Summary

Decreasing utilization of the Emergency Department (ED) is a priority for the system. Often, ED visits can be avoided if patients contact Geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ED vs. urgent care or primary care facilities. The study team is working to reduce ED utilization by including additional information in adult outpatient After Visit Summaries (AVSs). The study will involve will involve A/B testing different AVS versions, including 1) a version that encourages patients to contact Geisinger via different contact methods, 2) a version that includes a map to the patient's closest ConvenientCare location and accompanying information about ConvenientCare, and 3) a version that includes a self-triage guide. A control group will receive the current standard AVS. Analysis results will be assessed to determine which version is most effective at reducing ED use.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-03-08
• Study First Submitted QC: 2023-03-27
• Study First Posted: 2023-03-28
• Study Start: 2023-04-03
• Primary Completion: 2023-12-11
• Study Completion: 2023-12-11
• Status Verified: 2024-02
• Last Update Submitted: 2024-02-22
• Last Update Posted: 2024-02-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 239841

Inclusion Criteria

• Age 18+
• Has a Geisinger Primary Care Physician assigned
• Completes an outpatient office visit or telemedicine appointment at Geisinger

Exclusion Criteria

• The AVS was not printed according to the EHR, and the patient does not have an active MyGeisinger patient portal account, so they do not have a way to view the AVS

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Contact us first + urgent care map + self-triage	Urgent care map	Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
Contact us first	Contact information	Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention.
Contact us first + urgent care map + self-triage	Contact information	Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
Contact us first + urgent care map	Contact information	Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.
Contact us first + urgent care map + self-triage	Self-triage chart	Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
Contact us first + urgent care map	Urgent care map	Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.

Primary Outcome Measures

Name	Time	Method
Inappropriate ED visits	In the 30 days following the appointment	Visited the ED inappropriately (y/n); We will apply the NYU algorithm (Ballard et al., 2010) to determine whether an ED visit is inappropriate.

Trial Locations

Locations (1)

Geisinger Clinic; 🇺🇸 Danville, Pennsylvania, United States